System and method for facilitating manual and/or automatic volumetric imaging with real-time tension or force feedback using a tethered imaging device

ABSTRACT

According to exemplary embodiments of the present disclosure, apparatus, device and method can be provided which can provide imaging of biological tissues, e.g., luminal organs in vivo, using optical techniques in an automatic or semiautomatic manner. The exemplary apparatus, device and method can utilize a tethered capsule catheter with a mechanism for manual, semi-automatic or automatic traversing in the luminal organ with a controlled velocity and/or image quality. The exemplary apparatus can include feedback information about tension applied to the catheter during its movement that can be used to adjust velocity and assure patient comfort and safety for example during passing through natural sphincters and/or narrowing of the luminal organs and preventing from breaking of the catheter. The exemplary apparatus can also adjust velocity in order to provide good quality of acquired images, for example to engaged peristalsis and provide contact with the tissue. In one exemplary embodiment of the present disclosure, the exemplary mechanism for a controlled advancement of the catheter can be positioned outside of the patient&#39;s mouth, and can include a position sensor providing information about the position of the capsule in respect to the luminal organ for orientation of the acquired data.

CROSS REFERENCE TO RELATED APPLICATION(S)

The present application relates to and claims the benefit and priorityfrom International Patent Application No.PCT/US2015/013884 filed on Jan.30, 2015, which claims the benefit of priority from U.S. PatentApplication No. 61/934,298 filed on Jan. 31, 2014, the disclosures ofwhich are incorporated herein by reference in their entireties.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH

This invention was made with government support under R01CA103769-07awarded by National Institutes of Health. The government has certainrights in the invention.

FIELD OF THE DISCLOSURE

The present disclosure relates to catheters, and more specifically toexemplary embodiments of apparatus, systems and methods which facilitatemanual and/or automatic volumetric imaging with real-time tension orforce feedback using a tethered imaging device.

BACKGROUND INFORMATION

Catheters have been utilized in the past to obtain information regardingtissue sample within and/or externally from a body structure. A numberof catheters have been produced, including capsule catheters, includingthose which are tethered. However, controlled motion of such capsulecatheters may not have been easily effectuated.

Accordingly, there may be a need to address and/or overcome at leastsome of the above-described issues and/or deficiencies.

SUMMARY OF EXEMPLARY EMBODIMENT(S)

Exemplary embodiments of apparatus, systems and methods according to thepresent disclosure can be provided to facilitate manual and/or automaticvolumetric imaging with real-time tension or force feedback using atethered imaging device.

In one exemplary embodiment, apparatus, device and method can beprovided which can facilitate imaging of biological tissues, e.g.,luminal organs in vivo, using optical techniques in an automatic,semiautomatic and/or manual manner. The exemplary apparatus, device andmethod can utilize a tethered capsule catheter with a mechanism formanual, semi-automatic or automatic traversing in the luminal organ witha controlled velocity and/or image quality. The exemplary apparatus caninclude feedback information about tension applied to the catheterduring its movement that can be used to adjust velocity and assurepatient comfort and safety for example during passing through naturalsphincters and/or narrowing of the luminal organs and preventing frombreaking of the catheter. The exemplary apparatus can also adjustvelocity in order to provide good quality of acquired images, forexample to engaged peristalsis and provide contact with the tissue. Inone exemplary embodiment of the present disclosure, the exemplarymechanism for a controlled advancement of the catheter can be positionedoutside of the patient's mouth, and can include a position sensorproviding information about the position of the capsule in respect tothe luminal organ for orientation of the acquired data.

To that end, exemplary apparatus and method for determining a force onat least one section thereof within at least one anatomical structurecan be provided. For example, using a catheter first arrangement, it ispossible to obtain image data regarding (i) at least one first portionof the anatomical structure(s) and/or (ii) at least one second portionof the first arrangement, when the first arrangement is inserted withinthe anatomical structure(s). Further, using, e.g., a force measurementsecond arrangement, it is possible to determine the force on thesection(s) of the apparatus using the image data. According to a furtherexemplary embodiment of the present disclosure, the image data caninclude information that can be a difference information between asurface of the first portion and a surface of the second portion. Inaddition or alternatively, the image data can include information solelyregarding the second portion.

In another exemplary embodiment of the present disclosure, a positioncontrol arrangement can be utilized to provide an adjustable control ofthe position of the first arrangement using the determined force. Theposition control arrangement can include a plurality of rollers. Thecontrol of the first arrangement can be performed via a control of anoperator based on the determined force, and/or automatically using acomputer based on the determined force.

The determined force can include a pressure on the section of the firstarrangement. It is possible to use a computer which can be specificallyprogrammed and/or modified to effectuate a control of a position of thefirst arrangement, where the first arrangement can includes a capsuleand a tether which can be connected to the capsule. The control of thetether by the computer can be controlled using the determined force. Thesecond arrangement can determine the force by analyzing a strain on orof the tether. According to still another exemplary embodiment of thepresent disclosure, the first arrangement can include a capsule and afiber which is connected to the capsule. The second arrangement can beused to determine the force by analyzing a strain on or of the fiber.

In addition or alternatively, the image data can be obtained using aninterferometric configuration. The second arrangement can utilize theinterformetric configuration to determine a strain on the second portionso as to determine the force. A position sensor arrangement can beconnected to the first arrangement and configured to provide furtherdata indicative of a position of the first arrangement within theanatomical structure(s). A position control arrangement can be providedthat is configured to provide an adjustable control of the firstarrangement using the determined force and the further data. The secondarrangement can include a computer which can be configured toreconstruct at least one image of the first portion based on the furtherdata. The position sensor arrangement can includes an array of positionsensors. The first arrangement can include a capsule and a tether whichis connected to the capsule, and the sensors can be connected along alength of the tether at predetermined locations. The position controlarrangement can be or include a pullback arrangement which can beconfigured to provide a pullback of the position of the firstarrangement using the determined force.

These and other objects, features and advantages of the presentdisclosure will become apparent upon reading the following detaileddescription of embodiments of the disclosure, and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Further objects, features and advantages of the present disclosure willbecome apparent from the following detailed description taken inconjunction with the accompanying drawings showing illustrativeembodiment of the present disclosure, in which:

FIG. 1 is a diagram of an imaging system according to an exemplaryembodiment of the present disclosure, which can include a tetheredcapsule catheter with an automatic pullback mechanism and positionsensor;

FIG. 2 is a set of illustrations for exemplary data from a humanesophagus acquired with tethered capsule and imaged with an opticalfrequency domain system according to an exemplary embodiment of thepresent disclosure showing change(s) in the acquired data when theexternal tension on the capsule is applied by a lower esophagealsphincter;

FIG. 3 is a set of illustrations for exemplary data from a humanesophagus acquired with tethered capsule and imaged with the opticalfrequency domain system according to an exemplary embodiment of thepresent disclosure showing influence of the tissue contact on thequality of images;

FIG. 4A is a flow diagram of an exemplary method with a feedback loopfor the device velocity based on tension and image quality according toan exemplary embodiment of the present disclosure;

FIG. 5A is a cross-sectional illustration of a human esophagus forproviding a calibration of the system according to an exemplaryembodiment of the present disclosure;

FIG. 5B is a cross-sectional illustration of exemplary data from a humanesophagus acquired with the tethered capsule arrangement according to anexemplary embodiment of the present disclosure, and imaged with theexemplary optical frequency domain system according to an exemplaryembodiment of the present disclosure provide when both a capsule contourand a surface contour are within the tolerance of the tension andcontact, respectively;

FIG. 5C is a cross-sectional illustration of exemplary data from thehuman esophagus acquired with the exemplary tethered capsule arrangementaccording to an exemplary embodiment of the present disclosure, andimaged with the optical frequency domain system according to anexemplary embodiment of the present disclosure when the capsule contouris larger than tension tolerance, whereas the surface contour is withinthe contact tolerance;

FIG. 5D is a cross-sectional illustration of exemplary data from thehuman esophagus acquired with the exemplary tethered capsulearrangement, and imaged with the exemplary optical frequency domainsystem a cross-sectional illustration when the capsule contour issmaller than the tension tolerance, whereas more than 50% of the surfacecontour is outside of the contact tolerance;

FIG. 6A is a diagram of the imaging system according to anotherexemplary embodiment of the present disclosure, which can include thetethered capsule catheter with a pullback or push forward effectuated byrollers;

FIG. 6B is a diagram of the imaging system according to still anotherexemplary embodiment of the present disclosure, which can include thetethered capsule catheter with the pullback or the push forwardeffectuated by a threaded arrangement; and

FIGS. 7A and 7B are diagrams of different exemplary configurations ofthe imaging system according to still a further exemplary embodiment ofthe present disclosure, which can include the tethered capsule catheterand including a position information arrangement.

Throughout the drawings, the same reference numerals and characters,unless otherwise stated, are used to denote like features, elements,components, or portions of the illustrated embodiments. Moreover, whilethe present disclosure will now be described in detail with reference tothe figures, it is done so in connection with the illustrativeembodiments and is not limited by the particular embodiments illustratedin the figures and provided in amended claims.

DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS

FIG. 1 shows a block diagram of an optical imaging capsule cathetersystem/apparatus according to an exemplary embodiment of the presentdisclosure. This exemplary apparatus can include, e.g., amicrostructural imaging system 110 and an optical imaging catheterincluding a tether 100, a capsule 120 and an automatic pullbackmechanism 140 (which can also effectuate a push forward) mounted outsideof an imaged organ or structure 180. Exemplary The microstructuralimaging system 110 can utilize at least one of the following modalitiesand/or configurations optical frequency domain imaging, opticalcoherence tomography, spectral domain OCT, confocal microscopy,spectrally-encoded confocal microscopy, two photon microscope, secondharmonic microscopy, third harmonic microscope, CARS, stimulated Ramanmicroscopy, etc. For example, such exemplary imaging system 110 candetect an electro-magnetic radiation (e.g., remitted light) from anyobject or tissue surrounding the capsule 120 to acquire and/or determineinformation regarding microstructures on or in the object or tissue. Thepullback mechanism 140 can be mounted on the tether, handheld, mountedto a headset/mouthguard/chinrest, or attached to the imaging system 110.Information regarding the pullback (or the push forward) velocity cancomplement and/or be used with information about the orientation of thecapsule 120 in the esophagus by adding a position sensing mechanism 165inside of the base of the capsule 160 and/or its tip 170. Such exemplarymechanism can be also mounted behind the proximal end of the capsule 150and/or outside 180 of a human subject. The exemplary mechanism can bebased on marks on the tether, mechanical surface contact with aroller/encoder, speckle correlation or image correlation using acquiredoptical images or images from additional camera, by adding accelerometerand/or gyroscope based sensor, pressure sensor, temperature sensor,magnetic sensors, pH sensor etc. The exemplary mechanism can include afunctional segmentation of the tether, proximal to the tether relayingadditional physiological or localization measurements. The exemplarymechanism may include modules within or attached to the distal tip ofthe capsule to take measurements distal to the capsule.

When moving from manual operation of the exemplary catheter to theautomatic mode the main challenge is to maintain patient comfort duringpulling the capsule up the esophagus and passing lower and uppersphincter. It is important to adjust the capsule velocity whenever thepatient feels discomfort, e.g. when the esophagus strongly collapses onthe capsule preventing it from moving, which will apply tension to thecatheter. FIG. 2 shows a set of illustrations providing exemplaryresults from imaging human esophagus using a tethered capsule catheterwith the optical frequency domain imaging systems according to anexemplary embodiment of the present disclosure. In such exemplary case,the capsule 160 was pulled using the tether from the stomach 230,through lower esophageal sphincter 240 and 20 cm, up the esophagus 250.While the capsule 160 was moving up the esophagus, a side-viewing opticsenclosed inside of the capsule was rotated providing exemplarycircumferential cross-sectional images 202, 204, 206 of the tissuesurrounding the capsule. After a collection of the images from the fullcapsule pullback, a longitudinal cross sectional image 200 through thewhole dataset can be obtained. Each horizontal line in the image 200,e.g., starting from the center and moving to the sides showscross-section through an inner capsule wall 210, an outer capsule wall220 and the tissue 260. The circumferential image 202 can correspond toa start point of data collection in the stomach 230.

When the capsule 160 is being pulled up it passes lower esophagealsphincter 240 where the sphincter muscles apply external pressure on thecapsule 160 preventing its motion up the esophagus 250. This exemplarypressure can cause the whole catheter to stretch for a distance of lessthan few millimeters, which can be visible on the circumferential 204and longitudinal 200 images as artificial increase of capsule diameter215. The inner diameter 210 of the capsule imaged by an exemplaryinterferometric technique can be viewed as artificially extended withthe amount of tension, due to a stretching and elongating of the fiber102 in the catheter in respect to the reference arm. This can bequantified by real-time processing of the image*=s (e.g., based onsegmentation) of the inner 210 and/or outer 220 wall of the capsule 280,and comparing it to the calibrated diameter without any tension 290.Additionally the maximum tension tolerance 295 can be established forsafety during the procedure. This information can be used as, e.g., animmediate feedback to the automatic pullback (or push forward) mechanismor capsule operator performing procedure to slow down while passing thesphincters or any other narrower areas of any lumen. Configuration canimprove a comfort of the patient, and protect the catheter frombreaking, due to excessive force and stretching. Such information aboutthe tension 280 can be acquired during the procedure and used forassessment of the tension force from passage resistance, which in caseof lower esophageal sphincter for example could be used for monitoringand diagnosing of gastro esophageal reflux disease.

It can be important for the automatic pullback (or an automatic pushforward) to obtain good quality data from the whole imaged organ orpart(s) thereof. FIG. 3 shows another longitudinal cross sectional image300 obtained in a human subject. In this exemplary case shown in FIG. 3the capsule 160 was pulled using the tether from the stomach 330,through a lower esophageal sphincter 340 and about 20 cm up theesophagus 350. During the length of the pull-back the tissue position inrespect to t the capsule 160 was changing. Each horizontal line in theimage 300, starting from the center and moving to the sides showscross-section through an inner capsule wall 310, an outer capsule wall320 and the tissue 360. The tissue surface 380 can be delineated (e.g.using segmentation) to emphasize the tissue contact profile changes overthe whole dataset. If the exemplary technology used for tissue imaginghas limited imaging range, for example because of the optical or dataacquisition performance, a tissue profile tolerance 390 can beestablished, which can be in the fixed distance 395 from the innercapsule wall 310 and the outer capsule wall 320. Frame 302 shows anexample of a severe loss of a contact where more than 50% of thetissue's surface profile is outside the tissue contact tolerance ring390, which means that the image quality can be compromised and someinformation about the tissue will be missing. Frame 304 on the otherhand represents good contact with the tissue where almost 100% of thetissue's surface profile is inside a tissue contact tolerance ring 390,providing best quality and comprehensive image. A moderate contact frame306 can indicate the situation in which more than 50% of the tissue'ssurface profile is inside the tissue contact tolerance ring 390,providing reasonably comprehensive image. In some cases of imaging ofluminal organs in GI tract, the contact between the capsule 160 and thetissue can be provided using a natural peristalsis by having a subjectto dry swallow or sip water.

Based on the real-time processing of the acquired data and thecalibration of the imaging range of the system according to an exemplaryembodiment of the present disclosure, an automatic feedback (or pushforward) can be provided to the automatic pullback (or push forward)mechanism or the operator may stop when the contact with the tissue isnot sufficient. The exemplary mechanism can be further optimized for thepercentage of the tissue in contact and number of consecutive frameswithout contact before the warning sound signal. Further, a display onthe screen or automatic change of velocity can be generated. Thisexemplary information about loss of contact and response of the organ toswallowing 380 can be acquired during the exemplary procedure, and usedfor an assessment of the peristalsis and dynamics of thegastrointestinal tract, similar to exemplary results obtained frommotility measurements.

FIG. 4 shows a method according to an exemplary embodiment of thepresent disclosure for utilizing the exemplary system for controlledpullback velocity based on the tension and tissue contact feedback.After calibration (block 405) of the exemplary system outside of thepatient, the tension tolerance 400 and contact tolerance 410 can beestablished. After the capsule 160 is swallowed by the patient, theimaging procedure can begin, and the capsule 160 is traversing in the GItract either using automatic system, or operator control with automatedmeasurement. In both cases, the capsule 160 can travel with somevelocity V (block 430). The tissue images can be acquired (block 417)and processed in real time (block 419) to provide a capsule wall contour420 and a tissue surface contour 430, which can be compared with tensiontolerance 400 and contact tolerance 410, respectively (block 419). Ifany of the signals is out of the tolerance, the feedback is provided todecrease the velocity or completely stop the capsule (blocks 450, 455).The loop can be performed multiple times, and when the tolerance isregained the pullback can be continued (block 460). The exemplary systemcan be optimized for a number of the iterations of the feedback loopbefore the automatic system switches to manual mode for example.

FIG. 5A shows a cross-section of a human esophagus for providing certainparameters for a calibration of the system according to an exemplaryembodiment of the present disclosure. One of the possible ways can be torelease the tension from the catheter before the procedure and image thecapsule without any tissue surrounding it. The image can be processed toextract initial, no-tension capsule diameter 550, based on thatdimension establish the tension tolerance 500 and the tether length,which position at the image should be fixed for the whole study. Usinginitial capsule diameter 550 and imaging system specification, likeimaging range 540 the contact tolerance 510 can be calculated.

FIGS. 5B-5D show respective cross-sections of exemplary data from thehuman esophagus acquired with the exemplary tethered capsule arrangementaccording to an exemplary embodiment of the present disclosure, andimaged with the optical frequency domain system according to anexemplary embodiment of the present disclosure. For example, as shown inFIG. 5B, both feedback signals are provided within their tolerance, andthe velocity of the capsule can be maintained. As shown in FIG. 5C, thecontact with the tissue can be perfect (e.g., 100% of the tissue surfacecontour 530 inside of the contact tolerance), although the capsule wallcontour 520 is outside the tension tolerance 500 and the capsule shouldbe stopped for safety and comfort reasons. Because the contact tolerancecontour 510 is, e.g., always in fixed distance from the capsule wallcontour 520, it is in different position than provided in theillustrations of FIGS. 5B and 5C. The reversed situation is illustratedin FIG. 5D, where there is no tension at the tether but there is lessthan 50% contact with the tissue, and the capsule should be stopped toregain contact and provide best quality of acquired data.

According to another exemplary embodiment of the present disclosure,feedback from catheter tension, tissue contact and capsule velocity canbe used for optimal automatic volumetric imaging. For example, theexemplary automatic pullback (or push forward) configuration can utilizea translation stage in one exemplary embodiment of the presentdisclosure to pull and/or push the tether with controlled velocity. Suchexemplary configuration can utilize a motor attached to the reel to coilthe tether. In another exemplary embodiment shown in FIG. 6A, themechanisms can comprise one or more roller(s) 610, 615 which can includeone or more driven wheels and/or one or more free rolling guide wheels.Either or both of the driven or rolling guide wheels may be fitted withand/or include an encoder. Wheel assemblies may be replaced for easydisinfection and reuse. Encoders may reside behind sealed opticallytranslucent or magnetically conductive barriers to ease and/or simplifydisinfection for reuse. The rolling guide wheel(s) of the roller(s) 610,615 can also be used in manual mode for further, position/velocitysensing, and further controlled motion or in an automatic mode for acomputer-controlled motion. The exemplary mechanism can have severalmodes of operation controlled by the operator, e.g. free motion,controlled speed 1, 2, 3, etc., positional hold. According to stillanother exemplary of the present disclosure, an exemplary mechanism 650shown at FIG. 6B may utilize and/or include a threaded tether with arotating threaded collar 660. For example, such threaded collar wouldrotate within in a handheld or system mounted stage to advance thecapsule 120.

In addition to tension and tissue contact feedback (or push forward), itcan be beneficial for both the human operator in the manual mode and theautomatic pullback (or push forward) mechanism in an automatic mode tohave information regarding the velocity of the capsule to provide anappropriate coverage of the organ or part(s) thereof. In one exemplaryembodiment (see FIG. 7A), information about the velocity can be providedby an exemplary position sensing system 720, which can comprise of andor be configured to implement a number of features and/or components(e.g., a sensor array, etc.) that can be directly or indirectly fixed tothe tether 100. In one example, the position sensing system 720 that isfixed to the tether 100 at about 50 mm or farther from the capsule 120can have various shapes with beveled edges to prevent from scratchingthe tissue. In addition, or as an alternative, the component(s) of theposition sensing system 720 can fully surround the tether 100 or beprovided on one side of the tether 100.

In another exemplary embodiment (shown in FIG. 7B), exemplarycomponent(s) of the position sensing system 720 can be located orsituated in a flexible region 750 of the tether 100, e.g., closer thanabout 50 mm to the capsule 120. In this exemplary embodiment, thecomponent(s) of the position sensing system 620 should facilitate aflexure of the flexible region 750 proximal to the capsule 120, shouldhave a diameter that is (e.g.,) at most the diameter of a centeringelement of the capsule 120, and a length thereof should be (e.g.,) atmost the rigid length of the flexible element 750. In one exemplaryembodiment, the position sensing system 720 and/or the flexible region750 can comprise an array of sensors (e.g., pressure, temperature, pH,location sensors, etc.) or other optical, electronic and/or mechanicalsubsystem.

Electrical and/or optical signals can be delivered to the exemplarycomponent(s) of the position sensing system 720 wirelessly or with wiresinside or outside of the tether 100. The wires can be coiled along thelength of the tether 100 to maintain its flexibility and bendability.The wires can also or alternatively be delivered in an additional lumenbeing a part of the tether 100 or being attached to it on the outside.Information from the position sensor can be collected by the imagingsystem 110 and/or used in post-processing for correct reconstruction ofthe imaging data. This exemplary information can be also utilized forreal-time feedback to the catheter operator in manual mode and/or to theautomatic pullback (or push forward) mechanism in the automatic mode forpull-back (or push forward) velocity adjustment to provide full coverageof the imaged organ.

The foregoing merely illustrates the principles of the disclosure.Various modifications and alterations to the described embodiments willbe apparent to those skilled in the art in view of the teachings herein.Indeed, the arrangements, systems and methods according to the exemplaryembodiments of the present disclosure can be used with and/or implementany OCT system, OFDI system, SD-OCT system or other imaging systems, andfor example with those described in International Patent ApplicationPCT/US2004/029148, filed Sep. 8, 2004 which published as InternationalPatent Publication No. WO 2005/047813 on May 26, 2005, U.S. patentapplication Ser. No. 11/266,779, filed Nov. 2, 2005 which published asU.S. Patent Publication No. 2006/0093276 on May 4, 2006, and U.S. patentapplication Ser. No. 10/501,276, filed Jul. 9, 2004 which published asU.S. Patent Publication No. 2005/0018201 on Jan. 27, 2005, and U.S.Patent Publication No. 2002/0122246, published on May 9, 2002, thedisclosures of which are incorporated by reference herein in theirentireties. It will thus be appreciated that those skilled in the artwill be able to devise numerous systems, arrangements, and procedureswhich, although not explicitly shown or described herein, embody theprinciples of the disclosure and can be thus within the spirit and scopeof the disclosure. In addition, all publications and references referredto above can be incorporated herein by reference in their entireties. Itshould be understood that the exemplary procedures described herein canbe stored on any computer accessible medium, including a hard drive,RAM, ROM, removable disks, CD-ROM, memory sticks, etc., and executed bya processing arrangement and/or computing arrangement which can beand/or include a hardware processors, microprocessor, mini, macro,mainframe, etc., including a plurality and/or combination thereof. Inaddition, certain terms used in the present disclosure, including thespecification, drawings and claims thereof, can be used synonymously incertain instances, including, but not limited to, e.g., data andinformation. It should be understood that, while these words, and/orother words that can be synonymous to one another, can be usedsynonymously herein, that there can be instances when such words can beintended to not be used synonymously. Further, to the extent that theprior art knowledge has not been explicitly incorporated by referenceherein above, it can be explicitly being incorporated herein in itsentirety. All publications referenced above can be incorporated hereinby reference in their entireties.

What is claimed is:
 1. An apparatus for determining a force on at leastone section thereof within at least one anatomical structure,comprising: a catheter including an interferometric imaging systemdisposed within a capsule connected to a tether, the interferometricimaging system configured to obtain image data regarding at least onesurface of the capsule when the catheter is inserted within the at leastone anatomical structure; and a processor configured to determine aforce on the at least one surface of the capsule based on a change in adetermination of a diameter of the capsule based on the image data. 2.The apparatus according to claim 1, wherein the image data includes adifference information between a surface of the at least one anatomicalstructure and the at least one surface of the catheter.
 3. The apparatusaccording to claim 1, wherein the image data includes information solelyregarding the surface of the catheter.
 4. The apparatus according toclaim 1, further comprising a position control system which isconfigured to provide an adjustable control of the position of thecatheter using the determined force.
 5. The apparatus according to claim4, wherein the position control system includes a plurality of rollers.6. The apparatus according to claim 4, wherein the control of thecatheter is configured to be performed via a control of an operatorbased on the determined force.
 7. The apparatus according to claim 4,wherein the control of the catheter is performed automatically using acomputer based on the determined force.
 8. The apparatus according toclaim 1, wherein the determined force includes a pressure on the atleast one surface of the catheter determined based on the image data. 9.The apparatus according to claim 1, further comprising a computer whichis configured to effectuate a control of a position of the catheter,wherein the control of the tether by the computer is controlled usingthe determined force.
 10. The apparatus according to claim 1, processordetermines the force by analyzing a strain on or of the tether based onthe image data.
 11. The apparatus according to claim 1, wherein thecatheter includes a fiber which is connected to the capsule, and whereinthe processor determines the force by analyzing a strain on or of thefiber based on the image data.
 12. The apparatus according to claim 1,further comprising a position sensor which is connected to the catheterand configured to provide further data indicative of a position of thecatheter within the at least one anatomical structure.
 13. The apparatusaccording to claim 12, further comprising a position control systemwhich is configured to provide an adjustable control of the catheterusing the determined force and the further data.
 14. The apparatusaccording to claim 12, wherein the processor is configured toreconstruct at least one image of the first portion based on the furtherdata.
 15. The apparatus according to claim 12, wherein the positionsensor arrangement includes an array of position sensors.
 16. Theapparatus according to claim 15, wherein the array of position sensorsis connected along a length of the tether at predetermined locations.17. The apparatus according to claim 13, wherein the position controlsystem is a pullback system which is configured to provide a pullback ofthe position of the catheter using the determined force.
 18. Theapparatus of claim 1, wherein the change in diameter of the capsulecomprises an increase in diameter of the capsule.
 19. The apparatus ofclaim 1, wherein the tether comprises a fiber, and wherein the change inthe determination of the diameter of the capsule is based on the fiberelongating relative to a reference arm as a result of the force on theat least one surface of the capsule.